Dating and breast cancer...14 10 tips to boost self-esteem 18 Dating and breast cancer Real lives 10...

The breast cancer magazine ● Issue 29 Autumn 2016

Vita

Uncertainty is the worst thingI’m living with secondary breast cancer

Dating and breast cancer

IMPROVE SELF-ESTEEM with 10 simple tips

Lymphoedema Can you reduce the risk?

Wig styling Transform your look

Free

‘I had no idea men get breast cancer’

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Welcome to VitaIt’s October, which means Breast Cancer Awareness Month is here.

This year, Breast Cancer Care has launched a campaign called Secondary. Not second rate. Around 36,000 women in the UK are living with incurable secondary breast cancer right now. And we know that far too many of them are not getting the care and support they need to live well for as long as possible. So Breast Cancer Care is campaigning for change – to make sure that women with secondary breast cancer no longer get second-rate care. Claire is one of the faces of the campaign, and on page 8 she tells us about what it’s like to live with secondary breast cancer.

Low self-esteem is an issue that can affect anyone. But breast cancer and its treatment bring many changes that can have a big impact on self-esteem. On page 14, Isabelle Cullis suggests 10 simple things to try today that could help you feel better about yourself.

Elsewhere, we look at dating after a breast cancer diagnosis. We asked a handful of women, of different ages, to tell us all about their experiences. Many of them shared similar worries, such as how and when to bring up the topic of cancer, and how prospective partners might react to the news. You can read about their experiences – good and bad – on page 18.

Gareth [email protected]

On the cover6 Wig-styling tips 8 Uncertainty is the worst thing9 I had no idea men get breast cancer

12 Lymphoedema: can I reduce my risk?14 10 tips to boost self-esteem18 Dating and breast cancer

Real lives10 You have to find your new normal11 A caring community

Regulars3 Your letters and emails4 News and views

16 Your questions answered21 Recipes22 Fundraising25 Breast Cancer Care Services

In this issue

Vita Editor: Gareth Fletcher; Design: Henry Ireland. Vita is published by Breast Cancer Care, 5–13 Great Suffolk Street, London SE1 0NS. Tel: 0345 092 0800. Registered charity in England and Wales 1017658. Registered charity in Scotland SC038104. ISSN 1751-3081. © October 2016 Breast Cancer Care. All rights reserved. Vita is a FREE magazine. It is not to be sold, hired out, or otherwise reproduced or transmitted in any form or by any means without the written permission of the copyright holder. Twitter: @Vita_mag Facebook: facebook.com/breastcancercare

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Get in touch with VitaTweet @Vita_mag Email [email protected] Write Vita magazine, Breast Cancer Care, 5–13 Great Suffolk Street, London SE1 0NS

Don’t forget to visit Vita onlinewww.vita.org.uk

● Read our real-life stories and healthy living articles.● Download the latest and past issues.● Check out our blog on living with breast cancer.

Dear Vita

I have just finished reading the article about exercise [Issue 28], which I found very interesting.

I was diagnosed with breast cancer last July and had a lumpectomy in August. Tai chi was my lifesaver. I’ve held classes for about 10 years. Warm-up exercises and a set routine every day kept me motivated and moving. Luckily, I was able to keep teaching throughout the first three sessions of chemo. The last three chemo sessions were a bit tough, but visualisation of tai chi made me feel in charge of my body and helped me rest peacefully. I started teaching again throughout radiotherapy.

I want to let others know that a soft, gentle, controlled tai chi can be a positive form of exercise for some people when our bodies are being bombarded with surgery and drugs.

Sue

Dear Vita

I am 80 and was first diagnosed with breast cancer at the age of 32. I was seen by a consultant on a Friday, had a radical mastectomy on the Wednesday, spent about a week or more in a hospital ward where ̒women’s problems’ were dealt with, and was never told anything about what had been discovered (I didn’t ask).

Because I had a young family – three little girls aged 10, 8 and 5 – the worry was more about not being at work and who was caring for them while my husband was at work.

Since then, I have led a very active life and am always mindful of how lucky I have been.

Five years ago, I found a lump in the remaining breast. The visit to the breast clinic and the procedure was so different this time. The information I was given was helpful and reassuring, and being in a ward specifically for breast cancer patients was so good.

There is still a wonderful life after breast cancer (though not for everyone unfortunately) and big strides have and are still being made to improve the quality of life.

Mary

Dear Vita

I would like to thank you for my issue of Vita. When it fell on my doormat, I was having a low day and feeling just a little bit sad, having myself had 14 months of operations and treatment. But reading your magazine cheered me up.

Suzanne

@littlejem17Just received my Vita Summer edition, lots of good stories and uplifting articles @Vita_mag

Your letters, emails and tweets

News

News and viewsOn the road

Between September 2015 and April 2016, Breast Cancer Care’s first jointly branded roadshow, as part of a partnership with The Football Association, travelled over 4,400 miles to towns and cities across England.

BARB, as the bus was named by staff at the FA, featured a warm and friendly environment with interactive features on board to engage the public. It included a private booth where people could call our Helpline for support, a breast awareness app and DVD, and a range of information in written and audio formats to appeal to people from different communities.

Visiting high streets, public squares, places of worship, retail parks and a selection of Asda supermarkets, the roadshow aimed to raise awareness of the signs and symptoms of breast cancer. Speaking to the public revealed that people were largely unaware there were symptoms of breast cancer other than a lump, and that women of screening age did not know they should check their breasts between mammograms. Originally set to target 12,500 people, the roadshow finally reached almost 33,000 thanks to amazing support and commitment from our volunteers and staff.

Leave a mark

Breast Cancer Care’s bookmarks help spread the word about the essential services we provide. They also suggest ways that people can support our work. Can you help distribute bookmarks to ensure more people who need us know about us? If so, call Allison Turner on 020 7960 3508 or email [email protected] We’d be delighted to hear from you.

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Pink up your day!

The Big Pink – Breast Cancer Care’s colourful national fundraising event – is happening on 14 October. You can join in for one Big Pink day, and help us continue to offer care, support and information to anyone who needs it.

It’s simple and fun to take part. Whether you have a pink dress down day at work, a pink night in or pub quiz, every penny you raise will make a huge difference.

Whatever you do, make it pink so everyone knows, and together we’ll make this the biggest, pinkest national fundraiser yet!

Sign up at breastcancercare.org.uk/thebigpink or call 0300 100 4442 for your free fundraising kit.

News

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Secondary. Not second rate

A new report from Breast Cancer Care highlights which hospital trusts in England are recording the numbers of people diagnosed with secondary breast cancer. Part of the continuing Secondary. Not Second rate campaign, it follows previous stark findings about patients’ experience at diagnosis. People with secondary breast cancer often tell us that they feel invisible. This is echoed in the findings of the new report, which show that only about a third of hospital trusts are counting the number of people diagnosed with secondary breast cancer every year in full. Unfortunately, nearly one in five hospital trusts are not collecting any data. These trusts have no real idea of how many people are diagnosed each year and how many are living with the disease in their local area. They are, therefore, unable to plan services that can really support these patients. Find out more about our campaign and how you can get involved at breastcancercare.org.uk/secondary

Your looks

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Georgia Wilson looks at how you can transform your wig with a salon cut.

Wig-styling tips to transform your look

W hether for everyday wear or a special occasion, a good wig can give you confidence and help you look and feel great.

If you don’t like how your wig looks when you first try it on, you’re not alone. Many of us struggle to find a wig that’s both the right colour and has the length and style we want. You may also find that standard ‘off-the-peg’ wigs are denser and ‘bulkier’ than normal hair.

Create the style you wantA trained stylist will be able to take the weight out of your wig using thinning and layering techniques, which will give it an instantly lighter and more natural overall effect. Your wig can then be shortened, shaped and textured to create the exact style you want.

‘It’s very rare that a wig sits perfectly the first time you try it on, so wig cutting is a great way to customise it,’ says Tiziana Di Marcelli, Head of Education at Trevor Sorbie.

Trevor Sorbie MBE founded the charity mynewhair, which trains and supports a national network of independent salons that provide wig-styling services.

‘When you buy your wig,’ says Tiziana, ‘you can then just focus on the colour and length you would like, and leave the shaping to an expert.

‘It could be just as simple as adding in a fringe or some texture, but it’s this customisation that can make the wig look and feel more natural.’

Find your nearest salon at mynewhair.org/salon-finder

Many Toni and Guy salons offer specially trained hairdressers who can cut your wig. Visit toniandguy.com/charity/strength-in-style

A trained stylist can take the weight out of your wig

Your looks

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Top styling tipsJasmin Julia Gupta, leading cancer hair loss expert and founder of charity Cancer Hair Care, gives us her top tips.

Visit cancerhaircare.com for more wig tips.

For more information on hair loss and a list of headwear suppliers visit breastcancercare.org.uk/breast-cancer-hair-loss

1. Just a trim Most longer length wigs need a trim every now and then if worn regularly. Over time, the static from your body can cause the ends of the wig to go frizzy, a bit like split ends. This can make the wig appear bulky or out of shape. A quick snip of the ends will revitalise the style.

2. Feel at homeThere are many caring hairdressers who will offer a home visit if you prefer. If you don’t have a home hairdresser a good place to ask for recommendations is local women’s groups like the Women’s Institute. Charity mynewhair has mobile hairdressers nationally who can offer home services.

3. Chop and changeIt’s worth thinking about how your own hair will change. Many women tell me that initially they want their wig to exactly match their style before treatment. When they lose their hair they then say they feel a little strange putting on so much hair. I recommend that you try on a variety of wigs in varying lengths. After treatment, when it’s time to transition from wig to new growth (short hair) you could have your wig cut shorter to help prepare for this change.

Before After

Wig cutting is a great way to customise your wig and create the style you want

Real lives

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I didn’t know much about secondary breast cancer.

After my treatment for primary breast cancer, I felt quite positive that I could carry on with a normal life.

A few years later, I started getting a stabbing pain in my chest. I saw my GP, who was aware I’d had primary breast cancer and prescribed painkillers. I took them on and off for a year. Eventually I thought: this isn’t right, I shouldn’t be having a pain here for this long. So I rang my oncologist.

After an MRI scan and then a CT scan a few weeks later, I got a call from the hospital asking me to come in for the results.

I went on my own. I didn’t take anyone with me because I wasn’t expecting it to be bad news. But I was told they’d found secondary breast cancer in my sternum, and that it was not curable.

I rang my boyfriend in tears. It was devastating news, and I didn’t want to have to tell everybody. Further scans showed that I also had secondaries in my liver and lungs.

Everything changesThe uncertainty is the worst thing about having secondary breast cancer. It’s like having a time bomb ticking inside you and you don’t know if you have months or years.

The hardest part for me is knowing that at some point I’ll be leaving my three children without a mother. And I won’t be there for their milestones like watching them get married or having grandchildren.

It changes the way you think about everything. If I wanted to go and buy a pair of boots, I’d think: ‘Is it worth buying a pair of boots that cost £100 as I might only get to wear them once? Am I wasting my money? Should I be saving it for the kids’ future?’

Finding hopeWith primary breast cancer, I had a dedicated breast care nurse, who almost held my hand throughout it all and explained everything in great detail.

With secondaries, nothing’s been explained in great detail. I was told: this is the best medicine for you to take and it might give you some time. But you’re not told how much time and it’s just very scary.

Breast Cancer Care has been fantastic in supporting me and enabling me to meet other people in the same situation.

I’ve had a lot of support from friends and family. But they don’t always understand as well as somebody in the same position would. Speaking to people like me has been invaluable. When I first went to a Living with

Secondary Breast Cancer group in Oxford, I was a bit apprehensive about what it was going to be like. But everybody there was so friendly and helpful. They were just ordinary women like me going through the same thing I was. That some of them have been going through it for a number of years gives me hope.

Uncertainty is the worst thingClaire McDonnell – one of the faces of Breast Cancer Care’s Secondary. Not second rate. campaign – tells us about the reality of living with incurable secondary breast cancer.

There are so many uncertainties for women who have incurable secondary breast cancer, like Claire. Act today and join our Campaigns Network breastcancercare.org .uk/secondary

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Real lives

I n 2005 I went into hospital for a routine hernia operation. I was 62, it was the first time I’d had surgery, and

my surgeon asked if there were ‘any other little jobs’ I wanted done while under general anaesthetic.

I told him I had this funny little lump in my chest. He said it was probably a bit of fatty tissue and nothing to worry about, but it would be better to take it out.

When I came round after the operation my chest was unbelievably sore. The surgeon told me he didn’t like the look of the tissue he’d removed, and had sent it to the laboratory for testing. The results confirmed that I had breast cancer.

Laid lowI was absolutely shattered. I had no idea that men could get breast cancer. I’m not prone to breaking down in tears, but my diagnosis was devastating.

I called up my boys – I’ve got four sons – and told them I’d been diagnosed with breast cancer. They were shocked and very upset.

I had a mastectomy and went on to have nine months of chemotherapy,

I had no idea men could get breast cancerColin Ensor was devastated when he was diagnosed with breast cancer. Ten years later, he’s keen to raise awareness that the disease can affect men.

which was delayed by a week because of a fire at the hospital!

The chemotherapy was the worst part of my treatment, and laid me pretty low. I really didn’t want to lose my hair. I used a cold cap, and while I didn’t lose my hair in the end, it did turn from black to grey overnight.

Amazing supportMy boys couldn’t have been more supportive, and I’m very proud of them. I lived in Alderney, in the Channel Islands, and the people over there looked after me too. It’s a very close-knit community.

People are always staggered when I tell them I’ve had breast cancer. I talk about it a lot because I want to make men aware that they can get it. If men have the slightest problem, they should see their doctor and get it checked.

Life is tremendousBefore I was diagnosed with breast cancer, I went through a divorce, then later lost my business. But I refuse not to be upbeat.

I now have seven grandchildren, the youngest of whom is one, and they are

all phenomenal. Life is tremendous. I consider myself unbelievably fortunate

to have found the cancer so early. And, touch wood, I’m now fine.

This year, I’m taking part in Breast Cancer Care’s London fashion show as a model. Some people are poking fun at me for going on the catwalk. But I hope to show people there’s light at the end of the tunnel.

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Real lives

I t was the second time I’d had cancer. I was diagnosed with pancreatic cancer in 2007. I had major life-

changing surgery, was eventually given the all clear and thought that was that. Then in June 2014, my life fell apart again.

I was diagnosed with invasive lobular cancer in both breasts. I had a double mastectomy, chemotherapy and radiotherapy.

I’d compare the experience to getting on a roundabout you can’t get off for a couple of years. You just have to go with the flow.

After my second diagnosis, I feared the worst. I thought: here we go again. How many times am I going to have to go through this?

I’m now a year on from hospital treatment. I have lymphoedema in both arms, I’ve slowed up and go to bed earlier, but there is life after cancer. It’s about finding your new normal. You can be just as happy as you were before you were diagnosed.

FamilyCancer is really hard on a family.

I have four children. My youngest son is 16 and was starting his GCSEs when I was diagnosed. He witnessed me at my worst, when I could barely make

You have to find your new normal

Anne Maddox was diagnosed with breast cancer at 54, after she spotted a dimpling on her breast in the bathroom mirror.

it to the toilet to throw up, or when I was pulling out handfuls of hair. But he took everything in his stride and was amazing. He sat on my bed with me, held my hand and watched TV if my husband was away in the evening.

My daughter announced she was getting married two weeks before I was diagnosed. I was too sick to go on her hen do, but I went to all the dress fittings except the last one. My favourite photo from the wedding is when I ditched the wig and the photographer took a beautiful picture of us.

In an odd way, the cancer has brought us closer together.

Tickled PinkGoing back to work after 13 months off was really tiring, but helped me get back on track. I felt I’d been stuck in ‘patient mode’ at home, and going back to work ended that.

I work as a Community Champion for Asda. My boss, who was diagnosed with cancer two weeks after me, was the most amazing support. When he went back to work, he said: ̒we’ll do it together’. The company was so supportive. I had a phased return, all done at my pace.

I’ve been involved in Asda’s Tickled Pink campaign, raising money for Breast

Cancer Care, for five years. I’ve organised all sorts of fundraising

events. As a vicar’s wife, I do a lot of baking for bake sales – I make a pretty mean cupcake. We’ve had head shaves in store. I’ve sat in a bath of gunk for hours (I never want to do that again). And I once kidnapped a store manager and handcuffed him inside a cage.

I’ll do whatever it takes to get people involved!

Breast Cancer Care is celebrating 20 years of Tickled Pink. Asda’s campaign has raised £48 million and has funded the support of one in five of the women we’ve helped.

Real lives

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I was diagnosed with breast cancer at 48, having been to the GP after finding a dimple under my right breast. I didn’t

have an obvious lump. But I was very aware of breast cancer as my mum and aunt had had it.

Twelve weeks on from chemo finishing, I can’t believe how well I feel again. I’m back at work and enjoying life.

I hated having to put my family through the stress of it all, and I’ve found it difficult to admit I’m vulnerable and needed support, as I’m a strong, independent person.

There were some very down days, but the support of my friends and family was incredible and really helped me get through.

My body now is so different and it has been hard to come to terms with that. I’m planning to have reconstruction sometime next year, but want to be as fit and well as I can be before I go ahead.

Losing my hair was the thing I dreaded most, and the cold cap was something I was determined to do. It was horrible and an ordeal each time, but for me it was worth it as I never lost my hair. It thinned a lot, but it was important for me to look as normal as possible through chemo. My hair is now thick and healthy again, although I have had it cut shorter.

Sharing worriesAt the beginning, I didn’t want to burden anybody with my fears. So I used the internet a lot to find out more about breast cancer. I stumbled upon Breast Cancer Care’s Forum this way. I had never used an internet forum before, and for a while I just read other people’s posts.

I eventually started to use it myself, as I had fears and worries I wanted to share. Talking to other people going through what I was gave me a huge amount of support.

I used the Forum initially for advice, but as time went on I found I could offer support to other people too. There were some very active threads and I have also tried to answer new threads and reply to new users.

The ‘chemo monthly’ thread was also a lifesaver, as I could compare notes with a group of women going through chemotherapy at the same time. Everyone was so friendly and we got through the ordeal together.

Community ChampionI was flattered to be asked to be a Community Champion, as the Forum has given me far more than I could give back. But I hope I can be there for women at

the start of their breast cancer journey as they were for me.

My advice to anyone thinking of using the Forum is: don’t be afraid to join in active threads. People are welcoming and will take time to answer you, despite everyone facing their own challenges.

Visit forum.breastcancercare.org.uk to find a welcoming community who’ll offer practical and emotional support at any time of day or night.

A CARING COMMUNITY

Claire Short was flattered to be named a Community Champion in recognition of the support she gives to people on Breast Cancer Care’s online Forum.


Healthy living

I f you’ve been treated for breast cancer, you might be worried about your risk of

developing lymphoedema.Lymphoedema is swelling of the arm,

hand or breast and chest area, caused by a build-up of lymph fluid in the surface tissues of the body. It can be the result of damage to the lymphatic system, for example because of surgery or radiotherapy to the lymph nodes under the arm and the area around it.

It’s a long-term condition, which means that once lymphoedema has developed, it can be controlled but is unlikely ever to go away completely. But the symptoms of lymphoedema usually respond well to treatment and this means that, in most cases, it can be controlled.

Who’s at risk?People who’ve had surgery or radiotherapy to the armpit (known as the axilla) may develop lymphoedema at some time in their life. The risk is greater if you’ve had both of these treatments to the lymph nodes under the arm.

However, only the arm, hand, fingers, breast and chest wall on the same side as the affected breast are ‘at risk’ of developing swelling.

Being overweight may also put you at higher risk of lymphoedema.

Lymphoedema: can I reduce my risk?Katie Parsons explores how you may be able to lower your risk of this long-term condition after breast cancer treatment.

Five risk-reducing tipsWhile it’s not known exactly what causes lymphoedema, there are some things you can try that might reduce your risk of developing it.

Maintain a healthy body weightThere’s strong evidence that being overweight can increase your risk of developing lymphoedema. You can find some tips on how to lose weight safely on page 17.

Keep using your ‘at risk’ armYou’re more likely to increase your risk of lymphoedema by protecting your arm too much and not using it enough. Try to use your arm normally, but don’t overuse it to the point where it aches and feels heavy. Our Exercises after breast cancer leaflet may help, or you can watch our Eat well, keep active DVD.

Protect your skinGetting an infection in your ‘at risk’ arm, hand or breast can cause swelling, and may damage your lymphatic system, leading to lymphoedema. Moisturise daily and protect your skin from cuts, grazes and sunburn.

Exercises for long journeysDuring flights and long train or car journeys, do gentle exercises such as clenching and unclenching your fist and shrugging your shoulders.

Holiday tipsWhen travelling abroad, use protection against insect bites. You can also ask your GP for antibiotics to take with you if you’re travelling to a country where quick access to good-quality medical care is difficult, in case of infection.

Some people worry that flying might increase their risk of lymphoedema. However, there’s no evidence that air travel or cabin pressure can trigger lymphoedema, or that wearing a compression sleeve (usually used by people with lymphoedema) during a flight will help prevent swelling. In fact, an ill-fitting sleeve may cause more problems.

Healthy living


Other tips that might helpWhile there’s no strong evidence to support them, the following precautions may also help.• Wear comfortable clothing and avoid

tight-fitting jewellery.• Take care when removing underarm

hair. Waxing and razor blades can damage the skin and increase your risk of infection. Electric razors are gentler on the skin. You can use depilatory (hair removal) cream, but check first that you’re not sensitive or allergic to it.

• Avoid carrying heavy shoulder bags.• Hot baths, saunas and steam rooms

may put extra strain on your lymphatic system, so you could consider not using them regularly, or avoiding them altogether.

• Deep tissue massage and heat therapy will encourage more fluid to the treated area so you may want to avoid this on your ‘at risk’ side. However, many practitioners are now trained to work with people who have, or are at risk of, lymphoedema, so check with your therapist.

‘If you notice any swelling in your arm, hand, fingers, breast or chest wall, contact your breast care nurse or specialist team.’

QCan I have an injection, blood taken or blood pressure taken from the ‘at risk’ arm?

AThere are different opinions among healthcare professionals about using the ̒at risk’ arm for

these procedures. In the past, people were advised to

avoid using the ̒at risk’ arm, but there’s no strong evidence that taking blood or a blood pressure reading from the ̒at risk’ arm will cause lymphoedema. However, it’s recommended to use the unaffected arm whenever possible.

Moisturise daily to help protect your skin

Breast Cancer Care has recently updated the booklet Reducing the risk of lymphoedema. You can order or download a copy from the website breastcancercare.org.uk/publications or call the Helpline on 0808 800 6000.

If you have already developed lymphoedema, you might find our booklet Living with lymphoedema helpful.


Your health

S elf-esteem describes how we think and feel about ourselves, and usually refers to the value

we place on ourselves as a person. Unpleasant or stressful experiences can lower our self-esteem and positive experiences and achievements can help improve it.

Someone with low self-esteem tends to have a negative opinion of themselves and finds it difficult to recognise anything positive they’ve done or nice qualities they have. It’s common to have high expectations of ourselves and be more critical of ourselves than others. And it can be difficult to ignore our inner critic when it pipes up frequently.

Breast cancer and self-esteem

Breast cancer brings many changes that can have a big impact on self-esteem.

The physical effects of treatment (such as pain, fatigue and sleep problems) may mean you can’t do the things you used to, and this may persist for months or even years after treatment.

Changes to your body image – through surgery or other treatment side effects such as hair loss, lymphoedema and weight changes – can have a huge impact on how you feel about yourself. They may leave you feeling less feminine or unattractive.

10 tips to boost self-esteem

Many people struggle with their self-esteem after a diagnosis of breast cancer. Isabelle Cullis suggests some

simple ways to help you feel better about yourself.

A sense of uncertainty and loss of control can also affect your self-esteem, as can a change in your role. You might suddenly go from being an independent person – whether you’re working or being a full-time mother or carer – to being a vulnerable patient or ‘that person with breast cancer’.

Low self-esteem can have a big impact on your mood and everyday life. Many people experience a loss of confidence and motivation, and it’s common to feel low and anxious when you have breast cancer. You might avoid doing things you normally would, like seeing friends, attending social events and even engaging in hobbies or work. Low self-esteem often affects your relationships too.

Isabelle has worked as a psychology practitioner in the NHS and now helps co-ordinate Breast Cancer Care’s Moving Forward service.


Your health

10 ways to improve self-esteemImproving your self-esteem can be challenging and often takes time and effort. But there are some simple things you can do every day to help you feel better about yourself.

Make time for yourself

We often don’t spend enough time doing something we love or that makes us feel good about ourselves. Try to factor in some ‘me time’ each day or week and don’t allow yourself to feel guilty – you’ve earned it.

Be more mindful

We can easily get caught up in our thoughts and believe them to be facts. But in reality, thoughts are just thoughts and are not necessarily true. When you notice unhelpful thoughts such as ‘I’m rubbish’ or ‘I should be able to cope’, try adding the phrase ‘I’m having the thought that…’ before the thought, or say: ‘There goes that inner critic again’. Techniques like these can help us take our thoughts less seriously.

Set realistic expectations

Cut yourself some slack! Often we feel we should be able to manage or achieve certain things and we beat ourselves up when we can’t. Remind yourself of everything you’ve been through and pace yourself. There is such a thing as ‘good enough’.

Celebrate the small things

Focusing on positives can help us improve our mood and break negative thinking habits. Try noting down some positive things at the end of each day. Think about things that have happened, something you may have done or a compliment you received.

Don’t compare yourself to others (or yourself before cancer)

We all fall into the trap of comparing ourselves to other people, but we can also compare ourselves to our ‘old self’. For example, you might think about all the things you could do before cancer. This often results in us feeling low and bad about ourselves. Try to look at how far you have come instead and how you can continue to progress – this will help motivate you as well as improve your self-esteem.

Seek out supportive people

Surround yourself with supportive people who love and value you. You could also try Breast Cancer Care’s online Forum (forum.breastcancercare.org.uk) or Someone Like Me service.

Look after yourself

Eat well and exercise regularly. Improving physical wellbeing can improve your emotional wellbeing too. Exercise can give you an energy and mood boost, and eating well reminds you you’re worth looking after.

Set yourself a challenge

Maybe you want to get back into a hobby you used to enjoy or learn something new. Make an achievable plan and set yourself a realistic timeframe. Once you’ve achieved it, congratulate yourself and allow others to congratulate you too.

Be compassionate to yourself

Self-compassion is not about self-indulgence, but more about understanding when we’re struggling and not punishing ourselves for it. Watch out for that inner critic, and when you notice it ask yourself: ‘What would I say to a friend?’

Get support if you need it

If you’ve tried these tips and found they haven’t worked for you, speak to someone about getting some support. It can be challenging to ask for help, but your treatment team and GP will be aware of local counselling and psychology services that can help you explore these types of issues and support you to feel better about yourself.

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My oncologist has recommended I have

bisphosphonates as part of my treatment for primary breast cancer. What are bisphosphonates and why might I be having them?

Bisphosphonates may be used as part of treatment for primary breast cancer to reduce the risk

of the cancer spreading to other parts of your body (secondary breast cancer) in the future.

Bisphosphonates are drugs used to slow down or prevent bone damage. They’re often prescribed for people who are at risk of, or have, osteoporosis. Some treatments for breast cancer can increase your risk of getting osteoporosis and your bones breaking (fractures). Bisphosphonates reduce this risk.

Your questions answered

I’ve just received an appointment for my first mammogram since finishing

treatment, and I’m feeling very anxious about going and having to wait for the results. Is this normal?

Many women describe feeling anxious before going for check-ups after treatment

for breast cancer. This is particularly understandable when you go for your first mammogram. Returning to the hospital where you were diagnosed can bring back many memories at a time when you might be trying to start to move on from your experience. But many people find that their anxiety lessens with future appointments.

Regular mammograms are routinely done after treatment to check for any signs that the cancer has come back (recurrence). Most hospitals follow the recommendations set out by the National Institute for Health and Care Excellence (NICE) and will invite you for a mammogram every year for a period of time.

You will be told when to expect to get your results. The radiographer who does your mammogram won’t be able to give you your results straight away. This is usually done by letter once the mammograms have been checked by a radiologist (a doctor who specialises in interpreting x-rays). The time this takes can vary. In some hospitals the breast care nurses can tell you the results when they are available.

Waiting for the results of your follow-up mammograms can be a worrying and

stressful time. If you’re finding it difficult to manage, you can contact your breast care nurse for support.

You can also call our Helpline on 0808 800 6000 or you can share your worries with other people in a similar situation on our online Forum. Breast Cancer Care also runs Moving Forward courses in partnership with the NHS, across many locations in the UK. These are designed to help you adjust and adapt after treatment, while meeting others who have had an experience of breast cancer.

Bisphosphonates are also prescribed as treatment for people with secondary breast cancer in the bone. This is when cancer cells have spread from the breast to the bone. They can help strengthen existing bone and reduce the damage caused by the cancer

But recent research has shown bisphosphonates may also help to reduce the risk of breast cancer spreading to the bones and elsewhere in the body in post-menopausal women being treated for primary breast cancer. So some doctors are recommending this type of drug as part of treatment for breast cancer, which may also include surgery, chemotherapy, radiotherapy, hormone (endocrine) therapy and targeted therapy.

It’s not yet known how long you need to have bisphosphonates for if you have had primary breast cancer. But it’s likely you’ll have them for a minimum of three years. They can be taken either as a tablet or given by injection, usually every six months.

Most people seem to tolerate bisphosphonates well but like all drugs they do have some side effects. These vary according to which drug you’re having and your treatment team will discuss these with you, as well as the potential risks and benefits of taking this type of drug.

QQ

AA

Your questions answeredBreast Cancer Care’s experts answer your questions about breast cancer and its treatment.



• Cut down on sugary drinks, biscuits, cakes and chocolate.

• Cut down on alcohol. • Choose lower-fat dairy products such

as skimmed or semi-skimmed milk and yoghurts.

• Include beans and pulses in your diet.• Choose lean cuts of meat, and eat

less red and processed meat (such as bacon, ham and sausages).

• Choose unsaturated oils and spreads.

Some people find the support of a reputable slimming club helps with their motivation to lose weight.

Increasing the amount of physical activity or exercise you do can also help with weight loss. If you’re not used to exercising or haven’t exercised for a while, start off slowly and simply. Going for short walks, doing things around the house or gardening can all help. As you gradually build up your strength, you can choose an activity you enjoy. Try to build up to at least 150 minutes a week of moderate-intensity activity, such as brisk walking or cycling.

Maintaining a healthy weight through healthy eating and physical activity may

I’ve finished my hospital treatment for breast cancer and am now taking tamoxifen.

I’ve put on a bit of weight which I’m struggling to lose. Are there any tips that might help me?

Many people tell us their weight increases during breast cancer treatment. It’s not fully understood

why this happens but treatments such as chemotherapy, steroids (which are often given with chemotherapy) and hormone therapies can affect people’s weight. Some treatments can also bring on the menopause, and weight gain can happen during this time. Some people may be less active during and when recovering from treatment and crave higher calorie foods.

It might be helpful to check what your ideal weight should be with your GP or practice nurse. They can also offer advice on healthy eating. If you need or want to lose weight, it’s important to set realistic goals. Aim to lose about 0.5–1kg (1–2 pounds) a week. There’s so much information available about food and diets, and it’s often very confusing and conflicting. The following tips might be helpful.• Reduce your portion size.• Choose wholegrain varieties of bread,

rice, pasta and cereal.• Eat at least five portions of a variety of

fruit and vegetables a day.

also help reduce the risk of the cancer coming back.

Breast Cancer Care has a booklet Diet and breastcancer. We also have a DVD – Eat well, keep active after breast cancer. Call our Helpline on 0808 800 6000 to order a copy.


Q

A

Breast Cancer Care’s experts answer your questions about breast cancer and its treatment. Ask us

If you have a question about breast cancer, call Breast Cancer Care free on 0808 800 6000. You can also Ask Our Nurses by email: go to breastcancercare.org.uk/atn To order or download Breast Cancer Care’s publications, call the number above or visit breastcancercare.org.uk/publications


Hot topic

T he explosion of dating sites and apps may have revolutionised the way potential partners can meet

nowadays. And a quick Google search for ‘dating advice’ brings up countless pages dedicated to the topic. But if you’ve had breast cancer, there may be additional worries to negotiate when looking for a match.

Who better to help you navigate the world of dating after a breast cancer diagnosis than the women who’ve been there themselves?

The right timeOne of the first dilemmas a woman may face when meeting someone new is when and how to broach the subject of breast cancer.

‘Friends urged me to try online dating, but when’s the right time to let someone know that you only have one breast?’ ponders Penny, who was diagnosed at 52 in 2014. ‘Do I put it on my dating profile so nobody gets a shock?’

Sue, 47 and diagnosed 10 years ago, says she initially felt like she needed a plan for how and when to tell people. ‘But I soon realised it was a very individual thing and that if and when the time was right, I would broach it.’

The question of when to tell someone

‘Would like to meet…’ Dating after breast cancer

We asked a group of women to share their experiences of dating after a breast cancer diagnosis.

is closely linked to a fear of how they’ll react to the news.

‘I confess I feel terror at the idea that I might date someone, grow to like them and that they’ll bail out when they hear my history,’ says Penny. ‘Or even worse when we get intimate they are horrified by what they see.’

Sue also feared the reaction she might face. ‘I did have a fear that no one would want to be with me once they found out about it,’ she says. ‘I couldn’t imagine taking my clothes off in front of anyone again.’

Negative reactionsA few of the women we asked did report that some potential partners lost interest when the topic of breast cancer came up.

Penny recalls a date that she was set up on by a friend over a year after her diagnosis. It was inevitable, she says, that the subject would arise because her treatment was so recent. ‘It wasn’t until my date questioned me about what type of cancer I’d had that I realised how embarrassed I was about making the disclosure. It may have been bad timing, but swiftly after I told him my cancer was in my breast, he up and left. I hadn’t intended to talk about my breasts on my

first date, and it seemed he was just as reluctant to hear about them!’

Clair, 40 and diagnosed at 38, received a similarly curt response from an online suitor. ‘I did chat to one man who I really had a lot in common with and we got on really well. I decided to tell him and was shocked by his response. He normally wrote long messages but his response was: “I’m sorry to hear that, I’m not ignoring you I have to go out”. This really hurt.’

An amazing responseNegative reactions are not necessarily the norm, though, and some women find they needn’t have worried about how their date would respond.

‘I wanted to meet a man and him get to know me before telling him,’ says Clair. ‘I had almost given up hope when I received a lovely message. We chatted daily. I felt like I had met my soul mate. When he asked me for a date I decided he had to know, so I started typing the message while in a flood of tears. I was really scared of what his response may be. The anxiety became intense when I saw ‘Typing a message’ flash up on my phone. It seemed to take forever. His response was amazing, he said it really wasn’t an issue for him and he still

Hot topic


wanted to take me out.’Sue also found her initial fears of a bad

reaction to be unfounded. ‘I remember being incredibly nervous the first time I needed to tell someone,’ she says. ‘But he reacted in a totally accepting way, acknowledging how hard it must have been to tell him. Subsequent partners have also all taken it in their stride.’

Clair recommends getting to know someone a little and picking the right moment to tell them. ‘Although it hurts to be rejected,’ she says, ‘don’t give up. Dating sites do work, just be patient.’

Sue has similar advice for anyone worried about telling someone: ‘Tell potential partners at the time that feels right for you – don’t feel under pressure to say something the minute you meet someone. There are plenty of people out there who will be totally accepting of any changes as a result of breast cancer. If not, then this is their issue and not yours.’

An intimate topicAdded to the fear of telling someone is anxiety about becoming intimate for the first time.

‘I know of women in stable and happy relationships who feel shy about their ageing bodies,’ says Penny. ‘I wonder how they would feel about not having a breast to add to their insecurities!’

Sue says she was initially terrified about the prospect of intimacy with a new partner and what they might make of her surgery. ‘But without exception the men I have had relationships with have all been totally accepting,’ she says. ‘That’s not to say I haven’t felt self-conscious about it and really miss how I felt before breast cancer – there is a mourning for how it used to be.’

Anyone worried about this sensitive topic might find Breast Cancer Care’s booklet Your body, intimacy and sex useful.

We found loveDespite the worries common to most women who’ve been through breast cancer, we’ve heard several stories from

women who’ve gone on to start a new and loving relationship.

Jeanette, who was diagnosed at 45, went on her first date a year after diagnosis. He was a friend of a friend and knew about her cancer. ‘But I wasn’t sure if he knew I had had a mastectomy,’ says Jeanette. ‘Our relationship progressed and we got closer, but it was still never discussed.

‘I knew I would have to broach the subject one day, so I told him by text (it was easier than a face-to-face conversation) that I needed to go into hospital for another operation, my breast reconstruction. I was scared telling him because I didn’t know how he would

react. I gave him the choice there and then to walk away if he couldn’t cope. He was lovely and said these words I’ll never forget: “I love you for you”. It didn’t bother him that I only had one breast.’

And what about Clair’s first date? ‘I was very nervous but, as I had hoped, we hit it off instantly,’ she says. ‘He asked me about the cancer and we arranged a second date. Four months later, we are still together and very much in love.’

To read more women’s stories about dating after breast cancer, head to Vita online vita.org.uk

Books


The street-wise patient’s guide to surviving cancerBy Karol Sikora

Review by Carolyn Rogers

This book is written by Karol Sikora – a very experienced oncologist who is known for his passion about the treatment and care of people with cancer. The book is not breast cancer specific but gives an overview of cancer in general. It includes chapters on the biology of cancer, treatment, life after cancer and the future of cancer care. However, there are a few pages dedicated to just breast cancer and its treatment.

Double bookedBreast Cancer Care’s clinical nurse specialists review two recent books aimed at people affected by cancer.

Although it’s written in a chatty, conversational way it’s very factual and honest. The language used is quite complex at times – particularly when describing the various treatments – but does give a good and detailed description of how they work.

I think this is a good reference book for people diagnosed with and going through treatment for breast cancer to supplement more specific information, and will also be useful for friends or relatives who want to learn more about cancer in general.

Beauty Despite Cancer: recognise yourselfBy Jennifer Young

Review by Rachel Rawson

If you’re looking for a handy reference guide on how to maintain your appearance, then this book provides really practical information. From how to select a wig and looking after your scalp to applying make-up if your eyelashes have fallen out, it’s all in here.

It can be a minefield knowing how to look after your hair when it grows back, so I particularly liked the section on tips for hair regrowth and colouring.

The fact that the book has in-depth chapters that are supported by tips in list form makes reading easy. At the back of the book the author has added some excellent appendices covering a variety of subjects such as choosing a complementary therapist and ideas on how to get a better night’s sleep. These make a quick reference point if you don’t want to read the book in its entirety.

All in all, a handy guide to dip in and out of, full of tips on how to maintain your appearance through and after treatment.


Good food

Fiorentina spinach and egg wrap pizza Makes: 1 pizzaPreparation time: 15 minutesCooking time: 10 minutes

• 1 Mission Deli Original Wrap• 1 small bag baby spinach• 1 tomato, diced • 5 small balls of mozzarella • 10g Parmesan, grated • 2 tsp olive oil • salt and pepper • pinch of chilli flakes • 1 egg, cracked

1. Preheat your oven to 180°C fan. Place the wrap on a lightly oiled baking tray.

2. Blanch the spinach by putting it in a colander and pouring boiling water over it. Then, when it’s cool enough to handle, squeeze out the excess water.

3. Top the wrap with the parmesan, mozzarella, spinach and chopped tomato. Season with salt, pepper and chilli flakes and drizzle with olive oil

4. Cook in the oven for 3 minutes. Then remove, add the egg, return to oven and cook for 6 more minutes, until the egg is cooked. Remove, slice and share.

Give pizza chanceTry this delicious recipe created by food stylist and writer Rosie Birkett, using Mission Deli Wraps.

Pink products


ELEMISThe Hero Collection, £55 (worth £95), includes an exotic and harmonising body massage oil, firming neck and décolleté balm, bliss-inducing facial capsules and number one bestseller Pro-Collagen Marine Cream anti-ageing moisturiser. Elemis is proud to support Breast Cancer Care with a donation of £10,000. Available from elemis.com or 0117 316 1888.

SMINTSmint will donate 5p to Breast Cancer Care from every pack of tasty Smint Strawberry Mix (£1.15) sold. Available from leading Boots, WHSmith Travel and selected supermarkets and independent stores nationwide.

QVC We all know someone affected by breast cancer, which is why our friends at QVC have designed a jewellery range to support Breast Cancer Care. The Diamonique ribbon pin (£20 in gold, silver and rose gold) and Orla Kiely Poppy Charm Bracelet (£58) are available at qvcuk.com At least 60% of the sale price will be donated to Breast Cancer Care.

THE PINK STYLE LIST

Once again this October, Breast Cancer Care’s corporate partners are turning products pink and donating a percentage of the price to

Breast Cancer Care. We’ve picked some of our favourites

LINZI SHOESLinzi’s limited-edition Breast Cancer Care Ballerina Pumps (£15) are available at linzi.com Linzi will donate £2 from each pair of pumps sold to Breast Cancer Care.

STARBUY

Pink products


MISSIONWrap up a tasty treat with Mission Deli original tortilla wraps (£1.70). Mission Deli pledges a £50,000 donation to help women affected by breast cancer. Available from supermarkets across the UK.

ASDAThis October, we’re celebrating the 20th anniversary of Asda’s Tickled Pink campaign, which has raised an incredible £48 million so far. Happy birthday, Tickled Pink! The George Tickled Pink long-sleeve T-shirt (£8) and Tickled Pink Oral B Toothbrush (£25) are available in Asda stores and online while stocks last.

SKECHERSThe next evolution of athletic walking comes in the Skechers GOwalk 3 – Go Knit (£59, donation £5). Designed with Skechers Performance technology and materials specifically for athletic walking. Available from the Skechers UK website and most Sketchers stores.

PHOTOBOXAdd a touch of comfort and sophistication to any room with these photo cushions (£30). PhotoBox will donate £2 from each purchase to Breast Cancer Care. Available from photobox.co.uk

EDITOR’S

PICK


Events calendar

We’re calling for primary schools to take on our brand new walking challenge this October. It’s as simple as walking one kilometre in the school hall or playground with everyone dressed in one crazy, colourful item. And it’s all to raise money and show they care for the mums, dads, aunties and grans affected by breast cancer.

Find out more and register at breastcancercare.org.uk/crazy-care-kilometre

October November December

21 Crazy Care Kilometre30 Trick or Treat Run

2 The Show London 19 St Lucia Triathlon

4 Santa Run5 Carols by Candlelight, London 6 Carols by Candlelight, Sheffield

Visit breastcancercare.org.uk/get-involved


Service dates

Struggling to get back to ‘normal’ after treatment for breast cancer? Moving Forward courses provide information, support and professional guidance on how to cope with and adjust to life after treatment.

Christine Hall was diagnosed with breast cancer in October 2015, and attended a Moving Forward course in Nottingham in May 2016.

‘I felt I had not finished my journey with my breast cancer,’ says Christine, ‘and still had lots of questions about where I had been and where it was going.

‘Moving Forward was a fabulous experience. I was lucky to be part of a very supportive group. The professionals, gathered from many areas of the health service, communicated a lot of information in an easy-to-understand way. I learnt a great deal about breast cancer and, more importantly, about myself and my reactions to it.

‘Doing the course helped me feel much more comfortable with myself. The information and the companionship were very useful, and came at the right time.’

Moving ForwardMoving Forward courses take place throughout the UK.

England• Barnsley • Basingstoke • Birmingham • Bournemouth • Doncaster • Enfield • Essex • Grimsby • Huddersfield • Kent • Liverpool • London • North Tees • Nottingham • Manchester • Oxford • Poole • Scunthorpe • Sheffield • South Tees • Southampton • Warwick • Winchester • Worthing

Scotland• Edinburgh and the Lothians • Fife • Forth Valley • Greater Glasgow and Clyde • Lanarkshire • Livingston • Tayside

Wales• Abergavenny • Bangor • Bridgend • Bronglais • Cardiff • Haverfordwest • Holywell • Llanelli • Llantrisant • Neath Port Talbot • Newport • Rhyl • Swansea • Wrexham

Living with Secondary Breast CancerRegular meet-ups for people living with secondary breast cancer, with expert guest speakers.

• Bristol • Cardiff • Cornwall • Coventry • Derby • Dorset • Edinburgh • Forth Valley • Glasgow • Halifax/Huddersfield • Lanarkshire • Leeds • Liverpool • Maidstone & Tunbridge Wells • Manchester • Milton Keynes • North London/Hertfordshire • Oxford • Romford • Salisbury • Sheffield • Sutton South London • York/Harrogate

Find the right support for you

Call 0345 077 1893Visit breastcancercare.org.uk Email [email protected]

Support in your areaService spotlight: Moving Forward

Younger Women Together Two days of support for women aged up to 45.

• Bristol: 4/5 November • Liverpool: 3/4 February 2017

Lingerie Evenings • Llandudno: 13 October• Cardiff: 14 October • Haverfordwest: 20 October

Information SessionBreast reconstruction:

• Llandudno 19 October


Classified adverts

Anita Care Offering post-surgical ladies innovative and discreet breast forms alongside specially designed, beautiful lingerie and swimwear, which allows wearers to feel comfortable and confident in all areas of their life, without compromising on colour, style and luxury. For all enquiries please call 020 8446 7478 or visit www.anita.com

Banbury Postiche offers a fantastic range of acrylic wigs with a next day delivery service available. We have a Customer Care team to support you, whatever your needs. Our purely wigs range is guaranteed to have a style to suit and delight you. Please take a look at our website www.wigsuk.com or call 01295 757 408.

Betty and Belle Winner of ‘Best lingerie shop in the UK’ award. Exquisite lingerie and specialist bra fitting shop with an extensive range of bras and swimwear to suit mastectomy, lumpectomy and reconstructions. Bra alteration and pocketing service. Visit www.bettyandbelle.co.uk or call in at 35 Oxford Rd, Cheshire WA14 2ED; 0161 929 1472.

Nicola Jane Experts in post-surgery fashion since 1984. Our NEW collection for 2016 features beautiful bras and stunning swimwear that will help restore your confidence after surgery. All with fitted pockets to hold your prosthesis securely. Free returns and shops throughout the UK. Call 0845 265 7595 or visit www.nicolajane.com

Pebble UK Over 90 designs of seam-free compression arm sleeves with matching gauntlets or gloves, specifically designed for lymphoedema (swelling). Made with moisture-wicking fibres, unscented aloe vera treatment for skin-friendly softness and fine-knit construction for a lightweight feel. Available in three sizes, two lengths and two compressions. Call 0800 433 4757 or visit www.pebbleuk.com

Silima FOR YOU! Our 2016/17 catalogue brings you stylish and supportive lingerie. Please check out our value-for-money range of everyday bras from £17.95 each (Diana and Victoria) or treat yourself to our French design heritage with Amelie or Suzanne, the latest addition to our range. Look no further for fashion and femininity! Call 01295 220 524 or visit www.conturabelle.co.uk

SOMETHING PRETTY Glasgow based, offering a choice of pretty, feminine and comfortable bras that give confidence and a great fit. Our experienced team of prosthesis fitters can advise on the best choice of bras to suit your surgery or lighter weight prostheses for leisure Personal shoppers welcome. Visit something-pretty.co.uk or call 0141440 1999.

Trulife breast forms and accessories restore confidence, self-esteem and ultimately contribute to a better quality of life for women following breast surgery. With over 50 years of experience in breast care, we lead through innovation and offer the most natural, coolest and softest breast forms available. Call 0800 716 770 or to see our range visit www.trulifebreastcare.com

Womanzone ABC To see our latest ranges of swimwear, lingerie and prosthesis or to order an up-to-date brochure visit our website (www.woman-zone.co.uk) or call us on 01925 220 932. With over 50 years’ experience we can offer an unrivalled service of care and advice, including free fitting, made to measure swimwear and pocketing services.

Suburban Turban offers stylish, fashionable headwear and accessories for women experiencing hair loss. The collection offers styles for all occasions – from beautifully simple, super-soft jersey hats to chic berets and sparkling cocktail hats. We also offer a range of natural skincare products, chosen for their gentle, soothing benefits. To shop the range go to www.suburbanturban.co.uk or call 01306 640 123.

[email protected]

To advertise here

please email us at

OneBIG PINK day

to support anyone affected by breast cancer

By holding a Big Pink this October you’ll be helping us to be there for people when they need us.

Sign up today at breastcancercare.org.uk/thebigpink

Together we’ll make a difference.

If you have already sent us this form, you will continue to receive Vita four times per year. Breast Cancer Care volunteers will be sent Vita automatically. We will not pass your details on to any third parties. If you are a member of a support group or a healthcare professional and would like multiple copies, please call 0345 092 0808.

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Registered charity in England and Wales 1017658. Registered charity in Scotland SC038104. Registered company in England 2447182.

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